Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-19T09:29:38.279Z Has data issue: false hasContentIssue false

Cutaneous glucocorticoid receptor sensitivity and pro-inflammatory cytokine levels in antidepressant-resistant depression

Published online by Cambridge University Press:  28 October 2005

PETER FITZGERALD
Affiliation:
Department of Psychiatry & Alimentary Pharmabiotic Centre, University College Cork, Ireland
SINEAD M. O'BRIEN
Affiliation:
Department of Psychiatry & Alimentary Pharmabiotic Centre, University College Cork, Ireland
PAUL SCULLY
Affiliation:
Department of Psychiatry & Alimentary Pharmabiotic Centre, University College Cork, Ireland
KIM RIJKERS
Affiliation:
Department of Psychiatry & Alimentary Pharmabiotic Centre, University College Cork, Ireland
LUCINDA V. SCOTT
Affiliation:
Department of Psychiatry & Alimentary Pharmabiotic Centre, University College Cork, Ireland
TIMOTHY G. DINAN
Affiliation:
Department of Psychiatry & Alimentary Pharmabiotic Centre, University College Cork, Ireland

Abstract

Background. There is evidence to indicate that peripheral glucocorticoid receptor (GR) function is reduced in major depression, and a possible molecular explanation for this is the impact of raised pro-inflammatory cytokines. The topical steroid vasoconstriction assay provides a convenient probe of peripheral GR function. The present study sought to assess the sensitivity of peripheral GRs in antidepressant-resistant major depressives and investigate the association between GR sensitivity and circulating plasma cytokines.

Method. Nineteen antidepressant-resistant depressives together with age- and sex-matched healthy controls underwent the steroid vasoconstriction assay using three commercial preparations of corticosteroids containing clobetasol propionate 0·05%, betamethasone valerate 0·1%, and clobetasone butyrate 0·05%, corresponding to very potent, potent, and moderately potent steroid creams respectively. The pro-inflammatory cytokines, tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were measured using enzyme-linked immunosorbent assays. The severity of the depressive episode was assessed using the Hamilton Depression Scale (HAMD).

Results. Depressed subjects had a significantly reduced vasoconstriction response across all three strengths of steroid. They also had significantly higher concentrations of TNF-α and IL-6. There was a significant inverse correlation between TNF-α concentration and vasoconstriction response and also between the HAMD score and vasoconstriction response.

Conclusions. These findings suggest that cutaneous GR function is abnormal in antidepressant-resistant depression, that circulating TNF-α may play a significant role in this abnormality and that the efficacy of topical steroids in antidepressant-resistant depressives is reduced.

Type
Original Article
Copyright
2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)